What is the impact of COVID-19 pandemic, season and temperature on prevalence of childhood diarrhoeal cases and treatment in India during 2018-2021– A 41 months cross-sectional research study?

Abstract - Globally diarrheal illness is the second leading reason behind death in kids underneath 5 years accounting for 525 000 kids death annually, which can be treated and prevented if timely interventions are applied as well as can be prevented through safe drinking-water with adequate sanitation and hygiene. Global prevalence of childhood diarrhoea is about 1.7 billion cases per annum. SARS-CoV utilize the Angiotensin-converting enzyme 2 (ACE2) with the serine protease TMPRSS2 for S protein priming. ACE2 and TMPRSS2 are expressed in lung, as well as small intestinal epithelia, added to this the ACE2 is expressed in the oesophagus, liver, and colon; SARS-CoV-2 binds strongly with ACE2 (10–20 times) compared with other SARS-CoV. The purpose of this research is to examine the epidemiology of childhood diarrheal events during COVID-19-period and comparing it with the pre-pandemic period of 2018-2019 as well as monthly-seasonal-temperature variations during different months of pre-pandemic and pandemic period associated diarrhoea to identify any changes in the usual seasonal pattern of childhood diarrheal events. A total of 11171113 eligible childhood diarrhoea (0-5 years) and 1704819 Childhood diarrhoea treated in Inpatients (0-5 years) were analysed during the 41 month study period. A total of 11171113 (mean-272466.2; [95% Conf. Interval means] 250375.4-   294556.9) childhood diarrhoea (mean-; [95% Conf. Interval means]) (0-5 years), 1704819 (mean 41580.95-; [95% Conf. Interval means - 36458.75-    46703.15])  childhood diarrhoea treated in Inpatients (0-5 years), 7603860 (mean 185460-; [95% Conf. Interval means - 159578.8-    211341.2])  were included in this study on an all-India basis. The 41 months of study when grouped into two groups as pre-pandemic era and pandemic era shows that the Monthly /seasonally Prevalence of Childhood diarrhoea (0-5 years) were MAX in July 2019 monsoon season during pre-pandemic period with 418722 cases ([95% CONF. INTERVAL] 299758.7- 338763.3; STD. ERR.- 9427.519; MEAN-319261; STD. DEV- 46185.22; and MIN-261319 in December 2019, post monsoon season, See table- 1, 3, and 4; figure-5 and 6. During the COVID-19 pandemic period Monthly /seasonally Prevalence of Childhood diarrhoea (0-5 years) were MAX in February 2020 winter season during pre-pandemic period with 284075 cases ([95% CONF. INTERVAL] 188170.3 - 224635.3; STD. ERR.- 8600.616; MEAN-206402.8; STD. DEV- 35461.25; and MIN-158007 in April 2020. KEYWORDS: - SEASONAL VARIATION, DIARRHOEA, COVID-19, INDIA, PREVALENCE, TEMPERATURE VARIATION,